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Ask Dr. Gott 10/21
Ankle pain can be treated
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DEAR DR. GOTT: Eight months ago, I fell and broke my right ankle. A cast was put on, and I was sent home from the emergency room. That night, I was in great pain in my upper leg. I went back to the hospital, and, after several days there, I was told I had internal bleeding and was given four units of blood. That was eight months ago. I have some numbness in the leg from my ankle up to my crotch, my knee gives way and I can't depend on it. I am 82 years old and am using a cane. The doctors don't give me much hope of walking right again and say I have nerve damage. Please give me some hope of getting over this. I am taking gabapentin three times a day. I also wear a wrap around brace on my knee.
    DEAR READER: Ankle fractures are slow to heal, especially in senior citizens. Therefore, I'm not surprised to learn that you are still having pain nearly a year after your accident. I am surprised, however, that someone — preferably the orthopedic specialist who casted you — hasn't made a serious effort to return you to a life of independence. Needing a cane for eight months is not acceptable therapy unless the fracture was extensive (compound) or you required surgery to pin the bones back together.
    In my opinion, you need the following.
    1. The gabapentin is useful in cases of chronic-pain syndromes, such as seen in shingles and diabetes. It probably isn't helping you all that much, so stop using it. Ask your doctor to prescribe a non-narcotic analgesic, such as Lodine or Equagesic.
    2. Insist on receiving physiotherapy. Not only will this activity help strengthen you, but it will also relieve pain and help you get rid of that cane.
    3. If necessary, seek out a specialist for a second opinion. Pain-control doctors can provide amazing relief from discomfort.
    Let me know how this plays out.
    To give you related information, I am sending you a copy of my Health Report "Managing Chronic Pain." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: I am an 89-year-old woman living in a retirement village with a friend. I was a nurse with a variety of experiences from 1937 until 1982, when I retired.
    My friend and my doctor have copies of my living will. In this document, I spell out what I want and do not want if I become terminally ill. So far, I have most of my brain functions — maybe a little dim at times — but I hope if I lose my senses that my doctor will keep me comfortable and is not committed to prolonging my life. I also hope he will tell my friend whatever she needs or wants to know even if I cannot understand.
    DEAR READER: You have every right to define your preference with regard to treatment of a terminal illness. You seem to have taken the necessary steps by writing this in an appropriate document. Now I urge you to make absolutely certain that your family and physician are aware of your choices and that they will honor them when the times comes.
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